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NationsHearing vendor outlines provider recruitment and reporting; commissioners seek clarity on Virta timing
Summary
Aetna and NationsHearing discussed outreach to audiologists, a dedicated member line and quarterly reporting to address access problems; staff clarified Virta Responsible Prescribing takes effect July 1 for new users and Oct. 30 for existing users.
Aetna and NationsHearing presented a NationsHearing benefits overview and a proposed customer-service approach for State of Maine members. Presenters described a dedicated phone line, scripted escalation, and quarterly reporting that will include counts of member calls, escalations and provider recruitment activity. NationsHearing and Aetna said they will pursue co-branded mailings to encourage providers to join the program and will explore one-to-one contracts with audiologists to address geographic and bandwidth constraints.
Commission members and staff noted that provider bandwidth — not reimbursement — appears to be the primary barrier to onboarding providers; NationsHearing committed to quarterly reporting to the Office of Employee Health, Wellness and Workers’ Compensation and to provide data that Aetna will relay to the commission. Staff also discussed mapping out-of-network provider locations relative to members to understand mobile-unit usage versus brick-and-mortar access.
Separately, staff clarified confusion about GLP-1 medications and the Virta Responsible Prescribing program: the commission record states the Virta enhancement will take effect for new users on July 1, while existing users will be transitioned on Oct. 30; staff noted Virta has been available since fall 2024 via Capital Rx for some members.
